OKLAHOMA MEMBER ENGAGEMENT
NASHP Annual ConferenceOctober 17-19, 2016Pittsburg, PA
Presenter:Tywanda CoxChief of Federal & State AuthoritiesOklahoma Health Care Authority
OKLAHOMA: POPULATION 3,911,338 (2015)
Oklahoma Health Care Authority SoonerCare (Oklahoma Medicaid)
▪ One million members annually▪ 66 percent children▪ 60 percent of Oklahoma births▪ Patient-centered medical home
Oklahoma Health Care Authority SoonerCare (Oklahoma Medicaid)
▪ 1 million members annually▪ 66 percent children▪ 60 percent of Oklahoma births▪ Patient-centered medical home
OKLAHOMA: HEALTH
Tobacco use: 21 percent adult smokers Obesity: 6th worst in U.S. for adults and
high school students Heart disease: 1 in 4 Oklahoma deaths Infant mortality rate: 7.4 Poverty: 1 in 6
Source: BRFSS 2014 Adult Current Smokers
COLLABORATION WITH OSDH
Oklahoma State Department of Health▪ Oklahoma Health Improvement Plan▪ Oklahoma Perinatal Quality
Improvement Collaborative ▪ The Child Health Group▪ Infant mortality reduction▪ Shared health workgroups
ENGAGING MEMBERS: 3 PRONGED APPROACH
Clinical Engagement Approach
Technology and Social Media Approach
Agency Engagement Approach
IMPROVING BIRTH OUTCOMES THROUGH MEMBER OUTREACH
OHCA Population Care Management▪ Health Management Program▪ Practice facilitation and health
coaching SoonerQuit initiatives Community outreach and education
HIGH-RISK OBSTETRICAL CASE MANAGEMENT PROGRAM
Women identified as having a high-risk pregnancy receive an enhanced benefit package: Ultrasounds Non-stress tests Biophysical profiles Case management Throughout pregnancy
The full Population Care Management evaluation can be found at: http://www.okhca.org/research.aspx?id=87.
HEALTH MANAGEMENT PROGRAM (HMP)Health coaching includes: RNs trained in motivational interviewing Face-to-face interaction by practice-based coaches (embedded in PCP
practices) Telephonic interaction for high-risk members not aligned with a practice
with an embedded health coach Approximately 5,000 members engaged at a time
Practice facilitation: RNs trained in motivational interviewing and quality improvement Assist practices with improving office efficiency and effectiveness by
developing team-based care and improve quality of care provided to chronically ill patients
HMP OUTCOMES Health coaching had a net savings of $12.8 million (medical savings minus
administrative cost)
Practice facilitation had a net savings of $28.5 million (medical savings minus administrative cost)
HMP overall net savings in SFY2014 and SFY2015 is $41.2 million or 249 percent return on investment
95 percent of members were somewhat or very satisfied with their health coaching experience
88 percent of providers were somewhat or very satisfied with their practice facilitation experience
Health coaching participants incurred 44 percent less inpatient days than forecasted and 23 percent fewer ER visits than forecasted
Members aligned with a clinic receiving practice facilitation incurred 29 percent less inpatient days than forecasted and 8 percent fewer ER visits than forecasted
Full report can be found at: http://www.okhca.org/research.aspx?id=87under “Studies and Evaluations”.
PROVIDER INITIATIVE - TOBACCO CESSATION BEST PRACTICES
Evidence-based methodologies 5 A’s tobacco cessation
counseling Practice facilitation
PARTNERSHIP FOR TOBACCO CESSATION
SoonerQuit▪ Oklahoma Tobacco Helpline support▪ Outreach▪ Provider initiatives
Partnership between OHCA and TSET▪ 50 percent state share paid by TSET▪ 50 percent Medicaid administrative
matching
SMOKING PREVALENCE – OKLAHOMA MEDICAID
Do you now smoke cigarettes or use tobacco every day, some days or not at all?
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
CAHPS 2008 CAHPS 2010 CAHPS 2012 CAHPS 2013 CAHPS 2014 CAHPS 2015 CAHPS 2016 OUHSC 2016
47.8%45.5% 44.4% 43%
48%
36.7%33.4%34.4%
TEXTING SERVICES FOR MEMBERS
Connect4Health (Voxiva)▪ Text4baby (T4b): Pregnant women and
babies to one year of age▪ Text4kids (T4k): 1-18 years old▪ Txt4health (T4h): Older than 18 years
old
CONNECT4HEALTH HEALTH PLAN MESSAGES
Health plan messages are designed to support member engagement, satisfaction & retention: Re-enrollment /
re-determination Coverage information Services and benefits Incentives Member services numbers Connecting with lost
members
There's not much time left to renew Emily and Adam’s SoonerCare insurance. Please call 1 866 299 5634. If you already enrolled reply YES
Welcome to SoonerCare. You are covered for medical but not dental or vision services. There is no co-pay on doctor visits or prescriptions
SoonerCare has been trying to contact you. Please call 1 866 222 5938 to make sure you keep your insurance benefits
Here are some phone numbers for your phone book. Member Services 1 866 235 8864, Nurse Helpline 1 866 225 7789, Transport 1 513 227 1264
Re-enrollment reminder Benefits
Lost members Member services
Health plan messages are 100 percent customizable
CONNECT4HEALTH MESSAGING
text4baby: Don't forget your Dr.'s visit 3-8 weeks after giving birth. Your Dr. will tell you how your body is healing & talk about how you are feeling. Ask about birth control. You can get pregnant even before period is back. Drs. say wait 18 months between pregnancies for your body & baby's health.
T4b: Post-Partum Visit
text4baby: Baby should be able to move their arms & legs together, hold head up & smile at you! Questions? Ask Dr. at 4 month visit or call 800-311-2229. At the 4 mo visit, ask Dr. for the results from baby's hearing test. If baby has trouble hearing, ask Dr. about "early intervention" services to help.
T4b: Development Milestones
text4kids: Wow, James is almost 2! His Dr’s visit is coming up soon. Have you scheduled his 3 year visit yet? Reply 1 for Yes or Reply 2 for No.
T4k: Well Child Visits
text4kids: Wow! Lizzie is almost 5 and may be off to school this year! Ask Dr. if she is up to date on shots. he/she'll need her shot record to start school. Ask for a copy of her shot record for school at the next Dr's visit. Did you schedule the 5 year well visit yet? Reply 1 for Yes or 2 for No.
T4k: Immunizations
SoonerCare covers adult health care visits! Call your Doctor to schedule an appt. Need a doctor? Go to www.okhca.org/individuals.aspx?id=518
T4h: Benefits
If you smoke, we can help you quit! Talk to your Doctor about ways to help you quit and call OK Tobacco Helpline at 1-800-QUIT-NOW (800-784-8669)
If you are living with diabetes, it's important to have your HbA1c test and eye exam done every 12 months. Learn more at www.okhca.org/diabetes.
OKLAHOMA T4B ENROLLMENT: NATIONAL LEADER
Text4baby participants who enrolled between July 1, 2014 and June 30, 2015, by month, with estimated SoonerCare status and ration per 1,000 Medicaid-financed births, and cumulative enrollment since project launch, pregnant women and mothers, Oklahoma
T4B STATE ENROLLMENT CONTEST: 06/05/16 -10/08/16
Source: https://partners.text4baby.org/index.php/component/content/article/54-partners-get-involved/partners/495-2016-state-enrollment-contest
SOCIAL MEDIA
Social Media▪ Facebook ▪ Twitter▪ YouTube
Audiences ▪ Facebook: 86 percent female, 25-34
years old▪ Twitter: 62 percent female, 40 years old
SOCIAL MEDIA SUCCESSES
COMMUNITY OUTREACH AND EDUCATION
MEMBER ADVISORY TASK FORCE (MATF)
MATF
Consumer (member)
engagement Two-way dialogue
Inform agency policy and
programmatic decision making
Members and families feel
connected and included in
agency decisions
Bi-monthly
Face to face
Annual Tribal Consultation
Riverside Dental Event
Standing agenda item
Five Civilized Tribe Quarterly Meeting
Southern Plains Tribal Board
Health fairs
TRIBAL ENGAGEMENT
CONTACT
Tywanda CoxChief of Federal & State PolicyOklahoma Health Care Authority(405) [email protected]